Manual of the Medical Department (NAVMED P-117): Chapter 15: Medical Examinations: Introduction

15-9 Special Studies

Department of the Navy
Bureau of Medicine and Surgery

(1) It required, the studies listed below will be ordered, and results will be entered on the SF-88. The list is a composite of guidelines from the US Preventive Services Task Force and US Navy Committee on Disease Prevention and Health Promotion, published studies of evidence-based medicine and practice guidelines, and recommendations of various colleges, societies, and panels. The examiner may request other clinically indicated studies, but all studies will be completed well in advance of the actual examination. Required studies include:
(a) HIV, per SECNAVINST 5300.30 series.
(b) Serology for sexually transmitted disease.
(c) Lipid profile, including cholesterol, triglycerides, and high density lipoproteins (HDL).
(d) Sickle cell and G-6-PD, if not previously recorded in health record.
(e) Type 2 dental examination.
(f) Visual acuity, including refraction if indicated for special duty or visual acuity change; tonometry is required after age 40.
(g) Audiometry, baseline and every five years or as directed by OPNAVINST 5100.23 series.
(h) Electrocardiogram beginning with the medical examination most proximate to age 40 and routinely, thereafter, unless clinically indicated or required for special duty.
(i) Stool guaiac beginning with the examination most proximate to age 40 for members at high risk; beginning with age 50 for members at low risk for colon carcinoma.
(j) Chest x-ray if clinically indicated or as required for special duty.
(k) For females, pelvic exam, PAP smear, and breast exam results; after age 40, results of the most recent screening mammography.

(2) Specific laboratory data will be recorded using current terminology. Essentially negative or negative are considered appropriate phrases to describe laboratory results.

(3) For military entrance processing stations (MEPS), recruit training commands or depots (RTCs/MCRDs), and officer accession points (OCS, AOCS, NROTC, USNA), studies in article 15-9(1 )(a) through (9) are required for all active duty DON personnel; 15-9(1)(k) is required for all active duty DON female personnel. Reservists not reporting directly to active duty will have all required tests completed and results entered in health records before departing RTC/MCRD or OCS. Medical Department representatives (MDRs) must review each record for completion before finding an individual qualified for duty.

(a) For females, enlisted applicants are required to have a pelvic examination at MEPS but need not have a PAP smear until reporting to the RTC/MCRD. Officer candidates or applicants for direct commission are required to have a pelvic examination during the initial physical exam but need not have a PAP smear until reporting to OIS, OCS, or AOCS. Documentation of a normal pelvic examination and PAP smear within 6 months of enlistment or accession will preclude the need for these studies at MEPS, RTC/MCRD, or officer accession points but must become a permanent part of the health record.

(b) Tests listed in this article, if not conducted at an officer accession point or an RTC, must be completed within 2 months of entry. MDRs or unit commanders must ensure compliance.

(c) Reserve DON personnel not reporting directly to active duty must have all required tests completed and recorded in their health record before commencing annual training. MDRs are required to review health records on new members and obtain required studies for which results are not available. It test results disclose any condition considered disqualifying for entry, administrative separation for an EPTE condition is mandatory.